Author Archives: Craig Payne

About Craig Payne

University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger, dad. Follow me on Twitter, LinkedIn and Facebook.

Stretching for Haglund’s deformity? What am I missing?

I really do not get this one, perhaps someone can explain it to me.

Haglund’s deformity (pump bump, retrocalcaneal exostosis, Bauer bump, etc) is an enlargement of the bone at the back of the heel that is irritated by the footwear causing a bursitis and the painful symptoms. I do not think that there is anything controversial about this and what it is.

I recently did a bit of a dive into Haglund’s as I had to write something about it. What I was surprised and perplexed as is that probably over 90% of the articles I came across on this on websites recommended that calf muscle stretching be done to help Haglund’s.

If you want to have a look, check this Google search. Look at some of the sources for the “best exercises” for Haglunds! eg WebMD, Livestrong, American College of Foot and Ankle Surgeons etc. I was prepared to give some of them the benefit of the doubt in that they may be confused between an insertional Achilles tendinopathy and the bony bump of Haglund’s, but, no, they all generally defined it as a bony bump at the back of the heel and advised stretching exercises!

Can someone please explain to me why? Why would stretching the calf muscles stop the shoe from irritating an enlarged bit of bone at the back of the heel?

I did not bother for a literature search looking for evidence on this as I know there is none.

[I suppose some could argue that if the calf muscles are tight that this might cause excessive movement of the foot/heel in the shoe and increase the rubbing on the Haglund’s deformity, but I have not seen that and even if that was a problem, it would only help if the calf muscles were tight and only after months of stretching.]

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Eggplant for chilblains?

Hot on the previous topic of beetroot juice for chilblains, we have now got eggplants as an option! Or have we?

Some new research recently crossed my screen on “Antichilblain Components in Eggplant” – something like that is going to get my attention. Turns out that eggplant applied externally to relieve the symptoms of chilblains has been used in East Asia for quite some time.

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urine treatment chilblains

Should you pee on your chilblains to treat them?

It easy to come across recommendations that urine therapy should be used to treat chilblains with lots of references to “my mum” or “my grandma” used to use it and swears by it fixing their chilblains (Google it). There is not a shred of evidence that it helps except for the unreliable anecdotes and testimonials. You will occasionally have a patient ask about it, because they heard about it from their grandma or they Googled it.

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Does calcaneal apophysitis occur in adults?


Of course it doesn’t. Its a disorder of the calcaneal growth plate that can not happen after the teenager stops growing as that growth plate merges with the rest of the calcaneus and is no longer there to cause problems. So why are you writing a blog post for on does calcaneal apophysitis occur in adults? Good question, glad you asked it. Here is why:

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Cupping For Plantar Fasciitis

We all have seen those photos of swimmers at the Olympics with bruises all over their bodies and wondered, “whaaaaaaaaaat?”.

It is an alleged therapeutic technique known as cupping where the therapist places special cups on your skin to create suction to supposedly help with with pain and inflammation and as a type of deep-tissue massage.

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The Dilemma Faced by Athletes

One of my favorite reads from a few years ago (2017) was ‘The Athletes Dilemma’ by John Weston and I have just now re-read sections of it. Anyone who is working with athletes needs to read this book or at least be familiar with the issues that are addressed in the book. While the book is heavily weighted to the USA sporting context, the issues are applicable to any sport in any country and those issues are faced by all those working in sports medicine on a very regular basis.

The book does a deep dive into the length that professional athletes go to compete with little or no regard to the long term health consequences to themselves. Weston does an excellent analysis as to why they are so willing to do that. The institutions that facilitate this are also critiqued.

The risk of seeing the elite professional athletes do this is the example that they are setting for children for their sporting careers and the lengths that they may feel empowered to go to in order to succeed.

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